Risk for Childhood Lymphoma
Both Hodgkin lymphoma and non-Hodgkin lymphoma tend to happen more often in people
with certain severe immune deficiencies, including:
- those with inherited immune defects (defects passed down by parents)
- adults with human immunodeficiency virus (HIV) infection
- those treated with immunosuppressive drugs after
organ transplants (these strong drugs help hold back the activity of the immune system)
Kids who have had either radiation therapy or
chemotherapy for other types of cancer seem
to have a higher risk of developing lymphoma later in life.
Regular pediatric checkups can sometimes spot early symptoms when lymphoma is linked
to an inherited immune problem, HIV infection, treatment with immunosuppressive drugs,
or prior cancer treatment.
No lifestyle factors have been definitely linked
to childhood lymphomas. Usually, neither parents nor kids have control
over what causes lymphomas. Most cases are due to noninherited mutations (errors)
in the genes of growing blood
cells.
Diagnosis
Doctors will check a child's weight and do a physical examination to look for enlarged
lymph nodes and signs of infection. Using a stethoscope, they'll examine the chest and feel the abdomen to check for pain, organ enlargement,
or fluid build-up.
In addition to the physical exam, doctors take a medical history
by asking about the child's past health, his or her family's health, and other issues.
Sometimes, when a child has an enlarged lymph node for no apparent reason, the
doctor will watch the node closely to see if it continues to grow. The doctor may
prescribe antibiotics if the gland is thought to be infected by bacteria, or do blood
tests for certain types of infection.
If the lymph node stays enlarged, the next step is a biopsy (removing
and examining tissue, cells, or fluids from the body). Biopsies are also necessary
for lymphomas that involve the bone marrow or structures in the chest or abdomen.
The biopsy may be done using a thin hollow needle (this is known as needle aspiration).
Or, a small surgical incision might be made while the patient is under general anesthesia. Sometimes,
a biopsy may require a surgical excision under anesthesia. This means
a piece of the lymph node or the entire lymph node is removed.
In the laboratory, tissue samples from the biopsy are examined to determine the
specific type of lymphoma. Besides these basic lab tests, more sophisticated tests
are usually done, including genetic
studies, to distinguish between specific types of lymphoma.
To identify which areas of the body are affected by lymphoma, these tests are also
used:
- blood tests, including complete
blood count (CBC)
- blood chemistry, including tests of liver and kidney function
- bone marrow biopsy
or aspiration
- lumbar puncture (spinal tap) to check for cancer spread
to the central nervous system (brain and spinal cord)
- ultrasound
- computed tomography (CT) of the chest and abdomen, and sometimes X-rays
- magnetic resonance imaging (MRI)
- bone scan, gallium scan, and/or positron emisson tomography (PET) scan (when a
radioactive material is injected into the bloodstream to look for evidence of tumors
throughout the body)
These tests help doctors decide which type of treatment to use.
